CMS recently released ICD-10 updates for 2018. The update resulted in many additions, deletions, and revisions that took effect October 1, 2017. Many of the deleted codes were replaced with more specific codes. There were a total of 363 additions, 142 deletions, and 226 revisions.
When diagnosis codes change, suppliers are likely to experience an increase in rejected claims. If you are a respiratory supplier for example, CMS deleted a common ICD-10 code: I27.2 (Other secondary pulmonary hypertension). As a result, every order with this diagnosis and a service date after October 1 will reject until your staff intervenes. Staff must replace diagnosis I27.2 with one of the new, more specific codes: I27.20-I27.29 or I27.83.
To avoid delays caused by rejections, suppliers should proactively address outdated diagnoses. Run a report from your billing software that exports active and recurring orders to include linked diagnosis codes. Then, query a match to deleted codes and update affected orders and patient accounts with the most appropriate new code. Suppliers are permitted to modify diagnoses for billing purposes, without securing physician approval, as long as the underlying diagnosis is supported in the medical records.
To review the complete list of added, revised, and deleted ICD-10 codes, suppliers can go to the CMS 2018 ICD-10 CM and GEMs webpage and download the 2018 Code Descriptions in Tabular Order file. This file will contain multiple documents. The “icd10cm_codes_addenda_2018” is a useful file that shows all additions, deletions, and revisions in alphabetical order by diagnosis code.
Maximize your revenue potential and stay on top of industry changes by attending (K)notes, our bi-monthly event and publication covering current events and reimbursement happenings in the HME industry. In this event we will cover updates to proof of delivery, CMS appeal initiatives, competitive bidding relief prospects, the new HHS Secretary nominee, why your Medicaid crossovers have stopped paying, what is happening with the next competitive bid project Round 2019, and more. Our next event is on December 14, 2017 at 2:00 pm EST.
When diagnosis codes change, suppliers are likely to experience an increase in rejected claims. If you are a respiratory supplier for example, CMS deleted a common ICD-10 code: I27.2 (Other secondary pulmonary hypertension). As a result, every order with this diagnosis and a service date after October 1 will reject until your staff intervenes. Staff must replace diagnosis I27.2 with one of the new, more specific codes: I27.20-I27.29 or I27.83.
To avoid delays caused by rejections, suppliers should proactively address outdated diagnoses. Run a report from your billing software that exports active and recurring orders to include linked diagnosis codes. Then, query a match to deleted codes and update affected orders and patient accounts with the most appropriate new code. Suppliers are permitted to modify diagnoses for billing purposes, without securing physician approval, as long as the underlying diagnosis is supported in the medical records.
To review the complete list of added, revised, and deleted ICD-10 codes, suppliers can go to the CMS 2018 ICD-10 CM and GEMs webpage and download the 2018 Code Descriptions in Tabular Order file. This file will contain multiple documents. The “icd10cm_codes_addenda_2018” is a useful file that shows all additions, deletions, and revisions in alphabetical order by diagnosis code.
Maximize your revenue potential and stay on top of industry changes by attending (K)notes, our bi-monthly event and publication covering current events and reimbursement happenings in the HME industry. In this event we will cover updates to proof of delivery, CMS appeal initiatives, competitive bidding relief prospects, the new HHS Secretary nominee, why your Medicaid crossovers have stopped paying, what is happening with the next competitive bid project Round 2019, and more. Our next event is on December 14, 2017 at 2:00 pm EST.
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